Application of Contrast-Enhanced Ultrasound (CEUS)-guided percutaneous biopsy in the diagnosis of central-type lung cancer patients with bronchoscopy contraindications or failed

Abstract

To explore the diagnostic value of contrast-enhanced ultrasound (CEUS)-guided percutaneous biopsy in patients with central-type lung cancer complicated with atelectasis who have contraindications to or failed bronchoscopy. A total of 32 patients with central-type lung cancer complicated with atelectasis, who underwent CEUS-guided percutaneous biopsy due to bronchoscopy contraindications or failure in our hospital from February 2022 to February 2025, were retrospectively enrolled. The display rates of the tumor-lung interface by conventional ultrasound and CEUS were compared and analyzed. Taking pathological results as the gold standard, the diagnostic efficacy and safety of this technique were evaluated. The display rate of the tumor-lung interface by conventional ultrasound was 40.6%, while CEUS increased it to 96.9%. Among the 31 cases with clear tumor-lung interface, the enhancement onset time of all lung cancer lesions ranged from 10 to 17 s. In contrast, 80.7% (25/31) of atelectatic lung tissues showed earlier enhancement onset time. The central-type lung cancer lesions in 83.9% (26/31) of patients presented a slow-in and fast-out enhancement pattern, and 90.3% (28/31) of lesions showed hypo-enhancement. Non-enhanced necrotic areas were detected in 9 cases (28.1%). All 31 patients achieved successful puncture and obtained definite pathological diagnosis, with no severe puncture-related complications. For patients with central-type lung cancer complicated by atelectasis and who have contraindications or failed bronchoscopy, CEUS-guided percutaneous biopsy can effectively identify active tumor tissues, providing a reliable alternative for clinical pathological diagnosis and having good clinical application potential. Not applicable.